Workers Compensation Doctors

One of the most rewarding parts of being a chiropractor is helping patients get back to work after an injury. Recently in my ambler office, I had a patient that was injured at work. While standing at his work bench someone ran him over with a golf cart. Ouch. This patient entered my ambler, pa office with low back and hip pain. Together the patient and I have worked with both passive and active rehabilitation to enable him to keep his activities of daily living at a normal level. Workers compensation has also paid the bills for his physical therapy. This patient let’s call him bob had no out of pocket expense for his work injury except for the gas it took to get to my office . My chiropractic office click here

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Workers Compensation Doctors

One of the most rewarding parts of being a chiropractor is helping patients get back to work after an injury. Recently in my ambler office, I had a patient that was injured at work. While standing at his work bench someone ran him over with a golf cart. Ouch. This patient entered my ambler, pa office with low back and hip pain. Together the patient and I have worked with both passive and active rehabilitation to enable him to keep his activities of daily living at a normal level. Workers compensation has also paid the bills for his physical therapy. This patient let’s call him bob had no out of pocket expense for his work injury except for the gas it took to get to my office . My chiropractic office click here

Dr. Richard Schwartz /215-283-2844/ Ambler Chiropractic / Can Poor Posture Predict Mortality?

Dr. Richard Schwartz / 215-283-2844/ Ambler Chiropractic

Can poor posture

predict mortality?

Maybe so according to a recent study and that ain’t all! Turns out that posture (in this case thoracic HYPER kyphosis) is getting some attention in the literature and appears related to a wide range of ailments, of which increased risk of death is only one. Only problem is that chiropractors aren’t doing the research. OH NOOO!!!

Because while half of our profession has relegated spinal structure to the dustbin of chiropractic history in pursuit of more “sophisticated” theories, our MD and PT colleagues are more than happy to lay the scientific ground work relating spinal structure to a wide range of ailments. End Of Rant…promise.

First off…thanks to Dr. Roger Coleman at ScienceInBrief.com for making me aware of this research. For those of you who aren’t familiar with the ScienceInBrief.com
project, we review scientific articles on a wide range of subject which are of interest to chiropractors. Unlike this newsletter, very little of what we do at SIB is directly related to posture based chiropractic. But occasionally, I run across articles which are relevant for readers here at Postural Rehab. Here’s a recap of the article along with some thoughts on managing thoracic HYPERkyphosis.

Hyperkyphotic Posture Predicts Mortality in Older

Community-Dwelling Men and Women: a prospective study 1

The Facts:

a. The authors studied the association between thoracic hyperkyphosis and mortality in over 1300 individuals with a mean age of 73.

b. If the individual laid on their back and was unable to rest the head on the table without putting the neck into hyperextension they were considered to have thoracic hyperkyphosis.

c. Patients were followed for an average of 4.2 years.

d. Those “with hyperkyphotic posture had greater mortality rates. Increased severity of “kyphotic posture” appeared to be associated with a higher risk of mortality.

Discussion: Obviously, the inability to bring the head back to neutral resting position COULD be also caused by factors other than thoracic hyperkyphosis, but what’s important here is that POSTURE appears to be associated with early mortality. Interestingly, thoracic kyphosis was found to be twice as common in men (44%) as women(22%) in this study, which seems to be at odds with conventional thought that thoracic hyperkyphosis is commonly caused by osteoporosis, a condition much more common in women.

The “NORMAL” Thoracic Kyphosis

Obviously, a radiographic evaluation of the T spine gives us a much more accurate idea of the sagittal curvature.

Harrison defined the thoracic kyphosis as ELLIPTICAL in shape, having a Jackson’s (Cobb) angle of 44.2 degrees from T1-T-12. Realizing the difficulty of visualizing both T1 and T12 on the radiograph, Harrison recalculated the model to reflect a thoracic kyphosis of 33.3 degrees between T 3 and T10. 2

Vaz et al, define the average thoracic kyphosis as 47 degrees in healthy young adults. 3

Boseker et al, defined a range of “normalcy” between 20-50 degrees in healthy children. 4

So you can see that opinions vary as to what is actually normal. I encourage interested readers to come to do some reading and establish in their mind what they consider to be the appropriate upper limits of thoracic kyphosis. Personally, I generally tend to view curves in excess of 40 degrees (as measured from T3-T10) as suspect. That’s just my opinion based on my reading of the literature, but 40 degrees is an upper limit you will find frequently cited. Regardless of which value you consider appropriate, it is important to have some sort of firm upper limit, above which you will start considering clinical intervention.

Clinical Management:

A number of tools have been looked at for treating thoracic hyperkyphosis but definitive research is still sorely lacking. Some options you may want to consider are exercise, bracing, and spinal remodeling. Here are two simple, inexpensive tools I have found to be helpful.



Thoracic Rolls

One method of actively addressing the thoracic kyphosis is to simply place the patient over a large foam roll ( our Multipurpose Rolls in the 10-13″ range work well for this), have them raise their hips up, and then “roll” themselves up and down over the roll by alternately flexing and extending the knees. This does two things. First, it introduces a fulcrum effect into the mid T spine to help reduce the kyphosis. Secondly the rolling motion helps mobilize the spine and costovertebral articulations to promote a reduction of kyphosis.

Thoracic Arch

Another method is to simply allow the patient to passively rest over a foam roll or fulcrum for 20-30 minutes. This time frame allows for stretching of the paraspinal tissues to occur and for the spine to “remodel” into a reduced kyphosis. I use our Thoracic Archfor this purpose and we now have lots of doctors using these arches on a regular basis to remodel the T spine.

I generally start with the patient over the arch with the fulcrum at the apex of the kyphosis as shown above. Once they can comfortably relax for the full 20-30 minutes without any problems or soreness, I place a 1″ spacer beneath the arch to raise it up and increase the leverage effect into the mid thoracics. Occasionally, I may end up placing an additional spacer or two as needed to effectively introduce extension into the thoracics.

References:

1.Kado DM, Huang MH, Karlamangla AS, Barett-Connor E, Greeendale GA. Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study. JAGS 2004;52:1662-7

2. Harrison DE, Janik TJ, Harrison DD, Cailliet R, Harmon SF. Can the thoracic kyphosis be modeled with a simple geometric shape? The results of circular and elliptical modeling in 80 asymptomatic patients. J. Spiinal Disord Tech. 2002 Jun;15(3):213-20.

3. Vaz G, Roussouly P, Berthonnaud E, Dimnet J. Sagittal morphology and equilibrium of pelvis and spine.Eur Spine J. 2002 Feb;11(1):80-7.

4. Boseker EH, Moe JH, Winter RB, Koop SE. Determination of “normal” thoracic kyphosis: a roentgenographic study of 121 “normal” children. J Pediatr Orthop. 2000 Nov-Dec;20(6):796-8.

Chiropractic Care in Ambler, PA

What to Do If Injured, Chiropractic Care in Ambler, PA
215-283-2844

Automobile Accidents, Chiropractic Care in Ambler, PA

Understanding what to do when an accident happens, and what types of injuries can occur may save you time, money, and long-term medical care. A prompt physical examination is the best advice. A thorough examination by a chiropractic physician is a wise precaution to determine the presence or absence of “hidden” injuries. Confer immediately with your doctor of chiropractic who will determine the extent of any injuries.

Serious and costly injuries do not always result in immediate pain or bloodshed. Aside from the more dramatic wounds which require surgery or hospitalization, other serious and costly injuries may result from auto accidents. Doctors of Chiropractic are particularly well-qualified to detect and treat a wide variety of injuries of the spine, nerves, and other related structures.

 

Common Injuries:

Low-Velocity Injuries (under 10 mph), usually result from the rapid movement of the body during the accident. This movement may result in muscle strain, seat belt bruises or Traumatic Brain Injury (TBI). Other symptoms may be delayed, but pain and stiffness may occur within 12-36 hours after impact.

High-Velocity Injuries (over 10 mph), usually result from a second impact, the body hitting objects inside the vehicle such as the dashboard, steering wheel, or window. Common injuries of this kind include shoulder, head or knee hematomas, wrist fractures, neck sprains, concussions, and a variety of contusions.

Traumatic Cervical Syndrome, more commonly known as whiplash, occurs when the neck is forced through a rapid series of movements faster than the bones, muscles and ligaments can accommodate. Some symptoms include swelling, tenderness, weakness or pain in the neck and shoulder; sore throat and/or loss of voice, trouble swallowing; jaw problems; vomiting; flashing lights in the visual field; headache; light-headedness or dizziness; painful tingling sensations; visual disturbances or blurred vision; and ringing in the ears. In some cases pain may not present itself for 12-36 hours after impact. 

Horsham, Pa Chiropractic, Horsham, Pa / Horsham Chiropractor / Glenside, PA

Chiropractors warn ‘text neck’ incidences on the rise+

 

Society can add another ailment to the growing list of problems associated with using text messaging. Chiropractors are warning of a condition on the rise that they are calling “text neck”.

Text neck is caused by keeping the neck flexed for long periods of time, which often occurs when texting obsessively throughout the day. The positioning people use when sending text messages is generally a down gaze with the neck flexed to make the head look down. It’s not just texting either, sufferers who generally get this ailment may be spending too much times on other gadgets, such as iPads.


 

MSNBC’s Today Health reports, “This is a global epidemic,” says Richard Schwartz, a chiropractor who practices at the Advanced Chiropractic and Wellness Center in Ambler, Pa., Horsham, Pa Glenside, Pa.

Schwartz said,

“It’s starting younger and younger. There are more than six billion phones connected, and that’s not counting the Kindles, iPads, tablets and all these devices we rely on daily,” adding, “Go outside, to a restaurant, the supermarket, a gym, the airport and notice the posture of almost everyone around you. You will see this everywhere, and now multiply that by every city in the world.”

Schwartz noted 45 percent of his patients have the same complaint and all are connected to the positioning used when looking down at various forms of screens or gadgets.

The Telegraph reports, Rachael Lancaster, of Freedom Back Clinics in Leeds, said,

“Sufferers are increasing as the use of smart phones and tablet computers become more popular.”

Lancaster relates this to joints and tissues in the neck not “built” to handle being flexed for extended periods of time. Lancaster stated, “Imagine sitting on your ankle sideways for 10 minutes. It would feel stiff and sore when you returned it to its natural position,” adding, “That is exactly what people are doing with their necks. If people continue to put their necks in these positions, the body will gradually adapt to the stresses.” Another concern is the natural curvature of the neck reversing. Chiropractors are warning this can lead to other health issues such as headaches and other body pains in shoulders, arms and wrists. Over the long term experts are warning this could lead to permanent arthritic damage. Health experts are indicating that “text neck” can be mitigated by taking breaks and allowing the neck to sit in its natural positioning, and also repositioning the phone to be higher can help too. Additionally getting enough regular exercise might also help reduce the risks associated with text neck. Over the years since computers have become a part of daily life for a couple of decades now, ailments such as carpal tunnel syndrome, have been associated with heavy use. Being texting is relatively new in the scale of technology; there is perhaps not enough data to provide a rounded scenario of the long-term effects; however doctors appear to be reporting increased incidences of body pains related to technology. Now “text neck” can be added to the list. The medical community has long been concerned about the ill-health effects often linked to texting.

Horsham Chiropractor talks about Cold and Flu Season

Cold and flu season is around the corner, but Dr. Richard Schwartz, a Horsham based Pediatric Chiropractor, believes that doesn’t mean you have to become a victim and he has a 7-Pillar Strategy for Natural Health During Cold and Flu Season.  Because government organizations like the Center for Disease Control advice that everyone from 6-months to 100 years old be given the annual flu vaccines, most people think that the flu vaccine is the best way to avoid getting the flu. Dr. Schwartz, who has been practicing for over 12 years, advises that you inform yourself of the risks of the flu vaccine and then make a decision based on that information; the Institute of Medicine (IOM) now admits: “Vaccines are not free from side effects or “adverse effects.”

The good news is that you can be proactive with your health and immunity! If you follow Dr. Christine Anderson’s seven pillars of health outlined below, then you will have taken great steps to insure that you and your family’s immune system stays strong not only during cold and flu season, but always!

Here are Dr. Richard Schwart’s 7 Pillars of Natural Health for a Healthy Immune System:

1. Proper Rest/Sleep: Minimum 7 hours per night for adults and 10-12 hours for children. Getting to bed before midnight is more restful and rejuvenating. Sleep in a completely dark room to fully activate the pineal gland, an area of the brain that regulates our body’s natural cycles. Exercise daily, but not in the evening as the activity can cause you to revive! Remove electronics from the bedroom and cease your computer usage at least an hour before wanting to retire. Some herbs to help relax and calm are chamomile, skullcap, valerian, and passiflora. Homeopathic remedies include camomila, coffea cruda, and nux vomica. 5—HTP is a metabolized form of tryptophan that is the precursor of serotonin – the neurotransmitter responsible for making us feel sleepy. Chiropractic can help the balance between the sympathetic nervous system (the part that makes you go) and the parasympathetic nervous system (the part that slows you down.) Besides repair, rejuvenation, and immune building, sleep can also keep you slim by keeping cortisol (your stress hormone) levels down.

2. Hydration: Take your body weight and halve it – that is how much water you should be drinking per day in ounces. Pure water—preferably filtered of pollutants, chemicals, and heavy metals. So if you weigh 140 lbs, then you should drink 70 ounces of water minimum; this is almost 9 eight oz glasses of water per day. If you have anything dehydrating, such as tea, coffee or alcohol, then add one glass per drink. Your body is primarily composed of water and the metabolic processes need it to function and flush out waste.

3. Exercise: Everyday, at least 30 minutes. Dancing around the house counts. Running around the house after kids counts, but you probably could also do with some focused exercise for stress release! Moderate exercise stimulates the immune system, but sustained hard core exercise can cause your body to become stressed and rundown. Include cardio, strength, including core, and flexibility aspects into your workouts. Once you get past the initial 2 weeks and the soreness goes away you will find you have more energy, stamina, you sleep better, and your self esteem will get a boost, too. For all you parents out there, your children will also get a firsthand look at what it means to take care of themselves. Heck, take them along on the walk or bike ride and get out there and kick the soccer ball around! For more information on Exercise and Pregnancy and Pregnacy massage, go to visit Ambler Chiropractor Dr. Richard Schwartz .

4. Manage Stress: Most likely than not there will always be stress in your life. We actually need a little bit otherwise we wouldn’t get out of bed in the morning. But what will run our systems down is the chronic unrelenting stress that never ends and continually releases cortisol, which will cause our bodies to shut down and collapse! Deadline after deadline, one thing after another, and never having enough time in the day – these are the things that wreak havoc. Schedules help. Limiting time wasters such as TV, computers, email, and social networking is another. Pursue a hobby. Practice yoga or meditate. Take a bath. Exercise. Only you will know what it is that helps you to release stress and then whatever it is, do it on a regular basis.

5. Eat foods that are nourishing, and eliminate foods that are depleting: Whole, unprocessed plant-based foods are the way to ensure that you have the fuel to build your body up and keep it functioning. By consuming processed foods, such as soda, energy drinks, coffee, cakes, cookies, candy, chips, fast food, and fried foods we use up our precious resources and weaken our defenses. The immune system is shut down for 5 hours after consuming sugar! Milk, fruit juices and alcohol are all hidden sources of sugar. Green juices are a great way to start the day and will give you an energy boost you won’t believe and won’t cause you to crash later on. Nuts and seeds provide sustainable energy and fruits and vegetables provide antioxidants which help protect your body from breaking down. Once you start consuming whole foods, processed ones will lose their appeal and as your body is nourished you will naturally consume less food, so you may even lose weight with no diet and no hunger!!

6. Spinal Hygiene: Hygiene is a funny word, no? (BTW—laughter is next…) Hygiene means the science dealing with the preservation of health. And the best way to preserve the health of the spine is with regular chiropractic check ups. Chiropractic is based on the philosophy that the nervous system controls and coordinates ALL the functions in the body – including the immune system. So, if you have physical, emotional or toxic stress from accidents, day to day stress, or eating a less than perfect diet, then subluxations (spinal misalignments) can cause nerve signals to be altered so your body can not get the proper signals to function optimally. Gentle chiropractic adjustments can help the whole family survive and even thrive during cold and flu season! For more information on Spinal Health, go to http://www.mapleglenchiro.com/

7. Laughter-Meaningful relationships-Life Purpose: Laughter releases endorphins—our natural morphine and reduces stress. Love and caring causes secretory IgA to be released, which is our first line of defense in the immune system. Conversely, anger causes secretory IgA to drop. Knowing that you are making a difference to someone or something causes cortisol to lower—so volunteer or get a pet if you don’t feel that your life has purpose at this point in time. High levels of cortisol over a long period of time deplete our immune system.

If you would like to take some immune boosters to further fortify your defenses, then there are some natural remedies which can help. Gemmotherapy are the buds of plants and there are certain ones, like Briar Rose and Black Currant that can be taken preventatively and are great for kids. Taking antioxidants, such as vitamin A, C, E, and selenium can help. There is an association with immunity and vitamin D, which is actually a hormone – so it is best to have your levels checked before consuming a supplement. Getting 15 minutes a day of sun is safer than taking supplemental vitamin D, if you are in an area that has sun!

Take your omega 3’s—preferably from plant sources such as flax and algae (versus fish which have the potential for being contaminated with heavy metals and hormone disrupting chemicals). Herbs that are adaptogenic such as astralagus and ginseng may be helpful. Echinacea may be taken for 2 weeks at a time as a preventative. Other immune boosting herbs are medicinal mushrooms, olive leaf, garlic, and larch tree.

Please note that the substances listed above are for the purpose of example only. Before consuming any supplement or herb, please consult your health care practitioner. The decision about whether or not to vaccinate is a personal one and should be made with full informed consent.